Adjuvant external-beam radiation therapy (EBRT) improves survival in patients with operable, lymph node-negative pancreatic cancer, according to a report in the January 1st issue of Cancer. Adjuvant external-beam radiation therapy (EBRT) improves survival in patients with operable, lymph node-negative pancreatic cancer, according to a report in the January 1st issue of Cancer.

"Adjuvant radiation therapy is not associated with worse outcomes and should be considered in the management of surgically resected pancreatic cancer patients," Dr. Joseph Kim from City of Hope National Medical Center, Duarte, California told Reuters Health.

Dr. Kim and colleagues examined outcomes in 661 patients with lymph node-negative (N0) pancreatic cancer who received adjuvant EBRT and 1137 similar patients who received no radiation therapy.

Median survival was 20 months in the adjuvant EBRT group patients compared with 15 months in the no-radiation group, the authors report.

After excluding early deaths, there remained a survival benefit of adjuvant EBRT among patients with T3 lesions (median survival 20 months with EBRT compared to 16 months without EBRT), the investigators say, but the difference in survival among patients with T1 or T2 lesions was not significant.

"There is current debate whether radiation therapy should be administered in the neoadjuvant or adjuvant settings," Dr. Kim explained. "Standard treatment recommendations advocate EBRT in the adjuvant setting. EBRT should continue to be studied in the investigational setting in neoadjuvant protocols."

"A recent randomized phase III trial from Europe demonstrated a detrimental effect from the use of adjuvant radiation therapy," Dr. Kim continued. "These results have been largely discounted in the United States because of concerns regarding protocol deviation and disparate techniques of radiation delivery. Although our report was a retrospective analysis of a large cohort of US patients, it nevertheless demonstrates no detriment with adjuvant radiation therapy and even indicates that there may be a survival advantage with adjuvant radiation therapy."

The findings therefore support current US phase III trials that are investigating adjuvant radiation treatment, Dr. Kim concluded.